The right side of the picture represents direct to consumer (DTC) advertising. The Nexium pill commercial popped up while I was using the citation machine website. My friend says that pill has helped her out a lot with heartburn. However, the whole aura of the advertisement is anti-sustainability. It attempts to elicit curiosity from viewers by vaguely describing its product; the description is limited to “purple pill” as if trying to appeal to a viewer with any type of ailment that could be solved by a “purple pill.” Theoretically this audience base should be zero; a logical society would have no need to pursue the advertisement and find more about a magical remedy whose attributes are known no further than “purple.” Nexium’s placement of an ad on a well used website proves the contrary to my prediction of an audience of zero. This ad as well as the creepy Lunesta commercial and bottles of pills are placed with a cholesterol graph. The left hand side is accompanied by a U.S. oil production graph. The graphs represent the complexity of the flux of data we are exposed to daily and the added complexity that DTC advertising brings to our source of medical data. The peace sign picture represents camaraderie, philanthropy, understanding, logic, truth, and peace which are all essential to building sustainable medical practices. The lady doing yoga represents alternative ways (not prescription drugs) to enhance, supplement, and strengthen one’s mental and physical health.
Problem:
Prescription drug advertising steals attention and money from more important health care issues and from sustainability issues. In 1997 the U.S. FDA approved direct to consumer advertising of prescription drugs (Fraser). Since then it has been shown that pharmaceutical companies invest vast sums of money in advertising, and there is proof that the advertising is effective.
“According to ‘The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States,’ as a percentage of domestic sales in 2004, the pharmaceutical industry spent 24.4% on promotion and only 13.4% for R&D”(Leighton). This investment in advertising is at odds with what should be the mission of the pharmaceutical industry: to sell drugs that can improve and save lives. Consider the following:
“[M]any people, most of them in tropical countries of the Third World, die of preventable, curable diseases.… Malaria, tuberculosis, acute lower-respiratory infections—in 1998, these claimed 6.1 million lives. People died because the drugs to treat those illnesses are nonexistent or are no longer effective. They died because it doesn’t pay to keep them alive.”- Ken Silverstein, //Millions for Viagra, Pennies for Diseases of the Poor//, The Nation, July 19, 1999 (Shah)
The advertisements are effective at gaining public attention:
“For instance, a US Food and Drug Administration survey of US physicians showed that 47% felt pressure from patients to prescribe advertised drugs, 62% said DTC advertising had caused tension between themselves and their patients, and 92% said they could think of at least one patient who instigated discussion about an advertised drug.” (Metzl)
The elicited interest translates into money… “A GAO reviewed study found sales increases of $2 for every $1 spent on DTC advertising, and another study found $4.20 in sales generated from every DTC ad dollar spent” (Leighton and 9, “Impact of Direct-to-Consumer Advertising”)
Go Fix It Proposal:
Reverse the 1997 decision by the FDA to allow direct to consumer (DTC) advertising of prescription drugs with limited description of risks. The portions of the Food and Drug Adminstration Modernization Act of 1997 that allow "drug approval based on a single controlled clinical trial and confirmatory evidence" and that allow the creation of a "fast-track" drug approval process that depends on post approval studies should be nullified (Wilkes). My proposal mandates that drug advertisement should include all risks. This should eliminate drug commercials on the television and radio becaus it is difficult to list all the risk and accurately portray the medication in such a short amount of time. Doing so would positively affect the sustainability of our nation by helping to shift our national paradigm from one of quick fixes and a focus on the self to one focused on systematic and societal changes. The energy devoted to DTC advertising and heeding to its suggestions should be diverted to sustainability issues.
The money presently allocated for drug advertising can then be used for continued drug research, for advanced toxicology research, or it can be used to distribute medications to third world countries.
DTC advertising is not necessary to the success of pharmaceutical companies. DTC advertising is legal in only the U.S. and New Zealand (“A Gap in the Market”). The limited allowances of DTC advertising as well its novelty are factors that increase the feasibility of banning direct to consumer advertising.
The following link is one existing articulation of banning DTC drug advertising: Stop Drug Ads
Relation of DTC Advertising to the Matrix of Sustainability Problems:
One’s imagination of a physical ailment should be applied to sustainability issues, such as peak oil. The same imagination that is used to convince one’s self that they need a sleeping pill to fall asleep could be applied to convincing oneself that personal energy use should be reduced. The paranoia and hypochondria that arises out of self diagnosis mirrors the paranoia associated with visualizing the predicted outcome of reaching peak oil. However, DTC commercials advocate for citizen’s to focus on personal issues as opposed to societal issues. The commercials call for the American public to evaluate their level of happiness to determine the possibility of depression, while no piece of mass distributed information calls for Americans to consider the fact that American oil production peaked in the 1970s.
An interesting supporting quotation about hypochondria by Stephen Connor:
"The rise of hypochondria parallels precisely the rise of mercantile and
consumer medicine, in which quackery and credulity multiplied on each other,
and in which medical writing reached ever-expanding readerships.
Hypochondria is the clearest yet most complex expression of this social
churning of symptom and pathology. And it is as a result of this period of
expanded medical writing, in which illness and cure become ever more literary,
that the question of the interpretation of signs begins also to be more fraught."
The regulations that allow DTC advertise bolster corporate power. The FDA specifically states on their website:
· “Consumers should know that they may not necessarily be able to tell whether any specific DTC ad includes false or misleading information.” · “Federal law does not bar drug companies from advertising any kind of prescription drugs, even ones that can cause severe injury, addiction, or withdrawal effects.” · “What are ads not required to tell you.…if changes in your behavior could help your condition (such as diet and exercise)”
(“Prescription”)
Such allowances in no way help craft a benevolent corporation; these allowances enable pharmaceutical corporations to continue the pursuit of profit and avoid social responsibility. This mirrors an anecdote revealed in “The Corporation” in which a Monsanto v. Fox News case ruled that “falsifying news is not against the law.” Directly prohibiting DTC advertising will prevent, or at least eliminate one venue through which pharmaceutical corporations can announce false information.
DTC advertising allows underlying causes of medical problems to be ignored or minimized. DTC creates attention about the cure of the ailment and divert attention away from issues with the food production industry (discussed in “Food Inc.”) or toxicology issues spawning from the 100,000 new chemicals in our environment (discussed in “Homo Toxicus”).
There are also numerous studies surfacing that have researched the levels of prescription drugs in waters and the affects of prescription drugs on aquatic animals. For example, antidepressants can induce spawning, can be toxic to algae at certain levels, can reduce the ability to capture prey, and can reduce the ability to avoid predators (“Antidepressant Pharmaceuticals”). The following websites contain interesting information pertaining to pharmaceuticals and the environment.
Stakeholders: · U.S. Food and Drug Administration · Federal Trade Commission · Pharmaceutical Companies · American citizens · Medical Community
The US FDA is in charge of regulating the DTC advertising of prescription drugs. This authority was transferred to them in 1938 with the Food, Drug, and Cosmetic Act (Wilkes).
The Federal Trade Commission is in charge of regulating the advertising of over the counter drugs ("Prescription Drug Advertising: Questions and Answers"). They also regulated claims about health supplements (Leighton).
Pharmaceutical companies are the instigators of this entire issue. Their organizational structure as corporations forces them to consider profits over the well being of consumers. This is also the underlying reason why there is a “Bias Against Preventative Health Care.” Pharmaceutical lobbyists will create a difficult political environment in which to ban DTC advertising of drugs.
American citizens must call for and support the banning of direct to consumer advertisements. They must be willing to call for a more sustainable presentation of information. They must recognize the bias that accompanies facts supported by corporations, and that there are risks to accepting medical information from a corporation.
The connection between the medical community (researchers, doctors, professors) and the pharmaceutical companies should be regulated so that the profit interested of the companies do not alter or inhibit their intellectual progress in the medical field and their scientific evaluation of new pharmaceuticals.
References: “Antidepressant Pharmaceuticals in Two U.S. Effluent-Impacted Streams: Occurrence and Fate in Water and Sediment, and Selective Uptake in Fish Neural Tissue.” Melissa M. Schultz, Edward T. Furlong, Dana. W. Kolpin, Stephen L. Werner, Heiko L. Schoenfuss, Larry B. Barber, Vicki S. Blazer, David O. Norris, Alan M. Vajda. Environmental Science & Technology 2010 44 (6), 1918-1925
Connor, Stephen. "Beghosted Bodyhood: Hypochondria and the Arts of Illness." North-East Network for Medicine. Durham, 12 Jun 2008. Address.
Fraser, Jessica. "GAO calls for stricter FDA oversight of DTC drug ads." Natural NEws. N.p., 15 Dec 2006. Web. 27 Apr 2010. <http://www.naturalnews.com/021306.html>.
"Toxic Substances Hydrology Program." United States Geological Survey, n.d. Web. 29 Apr 2010. <http://toxics.usgs.gov/>.
Wilkes, Michael S., Robert A. Bell, and Richard L. Kravitz. "Direct to Consumer Prescription Drug Advertising: Trends, Impact, and Implications." Health Affairs 19.2 (2000): 110-128. Web. 30 Apr 2010. http://content.healthaffairs.org/cgi/reprint/19/2/110.pdf.
Other Go Fix It! Ideas: · Promote LED lighting and warn about mercury in CFLs · Make more stringent qualifications for FDA employees; mandate disassociation from previous employers that are in the same industry that the FDA regulates · Mandate distributed energy for any new corporate building · Improve the relationship between manufacturers and recyclers
Prohibit Pharmaceutical Advertising
Picture Description:
The right side of the picture represents direct to consumer (DTC) advertising. The Nexium pill commercial popped up while I was using the citation machine website. My friend says that pill has helped her out a lot with heartburn. However, the whole aura of the advertisement is anti-sustainability. It attempts to elicit curiosity from viewers by vaguely describing its product; the description is limited to “purple pill” as if trying to appeal to a viewer with any type of ailment that could be solved by a “purple pill.” Theoretically this audience base should be zero; a logical society would have no need to pursue the advertisement and find more about a magical remedy whose attributes are known no further than “purple.” Nexium’s placement of an ad on a well used website proves the contrary to my prediction of an audience of zero. This ad as well as the creepy Lunesta commercial and bottles of pills are placed with a cholesterol graph. The left hand side is accompanied by a U.S. oil production graph. The graphs represent the complexity of the flux of data we are exposed to daily and the added complexity that DTC advertising brings to our source of medical data. The peace sign picture represents camaraderie, philanthropy, understanding, logic, truth, and peace which are all essential to building sustainable medical practices. The lady doing yoga represents alternative ways (not prescription drugs) to enhance, supplement, and strengthen one’s mental and physical health.
Problem:
Prescription drug advertising steals attention and money from more important health care issues and from sustainability issues. In 1997 the U.S. FDA approved direct to consumer advertising of prescription drugs (Fraser). Since then it has been shown that pharmaceutical companies invest vast sums of money in advertising, and there is proof that the advertising is effective.
“According to ‘The Cost of Pushing Pills: A New Estimate of Pharmaceutical Promotion Expenditures in the United States,’ as a percentage of domestic sales in 2004, the pharmaceutical industry spent 24.4% on promotion and only 13.4% for R&D”(Leighton). This investment in advertising is at odds with what should be the mission of the pharmaceutical industry: to sell drugs that can improve and save lives. Consider the following:
“[M]any people, most of them in tropical countries of the Third World, die of preventable, curable diseases.… Malaria, tuberculosis, acute lower-respiratory infections—in 1998, these claimed 6.1 million lives. People died because the drugs to treat those illnesses are nonexistent or are no longer effective. They died because it doesn’t pay to keep them alive.”- Ken Silverstein, //Millions for Viagra, Pennies for Diseases of the Poor//, The Nation, July 19, 1999 (Shah)
The advertisements are effective at gaining public attention:
“For instance, a US Food and Drug Administration survey of US physicians showed that 47% felt pressure from patients to prescribe advertised drugs, 62% said DTC advertising had caused tension between themselves and their patients, and 92% said they could think of at least one patient who instigated discussion about an advertised drug.” (Metzl)
The elicited interest translates into money…
“A GAO reviewed study found sales increases of $2 for every $1 spent on DTC advertising, and another study found $4.20 in sales generated from every DTC ad dollar spent” (Leighton and 9, “Impact of Direct-to-Consumer Advertising”)
Go Fix It Proposal:
Reverse the 1997 decision by the FDA to allow direct to consumer (DTC) advertising of prescription drugs with limited description of risks. The portions of the Food and Drug Adminstration Modernization Act of 1997 that allow "drug approval based on a single controlled clinical trial and confirmatory evidence" and that allow the creation of a "fast-track" drug approval process that depends on post approval studies should be nullified (Wilkes). My proposal mandates that drug advertisement should include all risks. This should eliminate drug commercials on the television and radio becaus it is difficult to list all the risk and accurately portray the medication in such a short amount of time. Doing so would positively affect the sustainability of our nation by helping to shift our national paradigm from one of quick fixes and a focus on the self to one focused on systematic and societal changes. The energy devoted to DTC advertising and heeding to its suggestions should be diverted to sustainability issues.
The money presently allocated for drug advertising can then be used for continued drug research, for advanced toxicology research, or it can be used to distribute medications to third world countries.
DTC advertising is not necessary to the success of pharmaceutical companies. DTC advertising is legal in only the U.S. and New Zealand (“A Gap in the Market”). The limited allowances of DTC advertising as well its novelty are factors that increase the feasibility of banning direct to consumer advertising.
The following link is one existing articulation of banning DTC drug advertising:
Stop Drug Ads
Relation of DTC Advertising to the Matrix of Sustainability Problems:
One’s imagination of a physical ailment should be applied to sustainability issues, such as peak oil. The same imagination that is used to convince one’s self that they need a sleeping pill to fall asleep could be applied to convincing oneself that personal energy use should be reduced. The paranoia and hypochondria that arises out of self diagnosis mirrors the paranoia associated with visualizing the predicted outcome of reaching peak oil. However, DTC commercials advocate for citizen’s to focus on personal issues as opposed to societal issues. The commercials call for the American public to evaluate their level of happiness to determine the possibility of depression, while no piece of mass distributed information calls for Americans to consider the fact that American oil production peaked in the 1970s.
An interesting supporting quotation about hypochondria by Stephen Connor:
"The rise of hypochondria parallels precisely the rise of mercantile and
consumer medicine, in which quackery and credulity multiplied on each other,
and in which medical writing reached ever-expanding readerships.
Hypochondria is the clearest yet most complex expression of this social
churning of symptom and pathology. And it is as a result of this period of
expanded medical writing, in which illness and cure become ever more literary,
that the question of the interpretation of signs begins also to be more fraught."
The regulations that allow DTC advertise bolster corporate power. The FDA specifically states on their website:
· “Consumers should know that they may not necessarily be able to tell whether any specific DTC ad includes false or misleading information.”
· “Federal law does not bar drug companies from advertising any kind of prescription drugs, even ones that can cause severe injury, addiction, or withdrawal effects.”
· “What are ads not required to tell you.…if changes in your behavior could help your condition (such as diet and exercise)”
(“Prescription”)
Such allowances in no way help craft a benevolent corporation; these allowances enable pharmaceutical corporations to continue the pursuit of profit and avoid social responsibility. This mirrors an anecdote revealed in “The Corporation” in which a Monsanto v. Fox News case ruled that “falsifying news is not against the law.” Directly prohibiting DTC advertising will prevent, or at least eliminate one venue through which pharmaceutical corporations can announce false information.
DTC advertising allows underlying causes of medical problems to be ignored or minimized. DTC creates attention about the cure of the ailment and divert attention away from issues with the food production industry (discussed in “Food Inc.”) or toxicology issues spawning from the 100,000 new chemicals in our environment (discussed in “Homo Toxicus”).
There are also numerous studies surfacing that have researched the levels of prescription drugs in waters and the affects of prescription drugs on aquatic animals. For example, antidepressants can induce spawning, can be toxic to algae at certain levels, can reduce the ability to capture prey, and can reduce the ability to avoid predators (“Antidepressant Pharmaceuticals”). The following websites contain interesting information pertaining to pharmaceuticals and the environment.
"Prescription Drug Pollution May Harm Environment"
“Drugs in the Water”
“Are Pharmaceuticals in Your Watershed?”- USGS article
United States Geological Survey- Toxic Substances Hydrology Program main page
Stakeholders:
· U.S. Food and Drug Administration
· Federal Trade Commission
· Pharmaceutical Companies
· American citizens
· Medical Community
The US FDA is in charge of regulating the DTC advertising of prescription drugs. This authority was transferred to them in 1938 with the Food, Drug, and Cosmetic Act (Wilkes).
The Federal Trade Commission is in charge of regulating the advertising of over the counter drugs ("Prescription Drug Advertising: Questions and Answers"). They also regulated claims about health supplements (Leighton).
Pharmaceutical companies are the instigators of this entire issue. Their organizational structure as corporations forces them to consider profits over the well being of consumers. This is also the underlying reason why there is a “Bias Against Preventative Health Care.” Pharmaceutical lobbyists will create a difficult political environment in which to ban DTC advertising of drugs.
American citizens must call for and support the banning of direct to consumer advertisements. They must be willing to call for a more sustainable presentation of information. They must recognize the bias that accompanies facts supported by corporations, and that there are risks to accepting medical information from a corporation.
The connection between the medical community (researchers, doctors, professors) and the pharmaceutical companies should be regulated so that the profit interested of the companies do not alter or inhibit their intellectual progress in the medical field and their scientific evaluation of new pharmaceuticals.
References:
“Antidepressant Pharmaceuticals in Two U.S. Effluent-Impacted Streams: Occurrence and Fate in Water and Sediment, and Selective Uptake in Fish Neural Tissue.” Melissa M. Schultz, Edward T. Furlong, Dana. W. Kolpin, Stephen L. Werner, Heiko L. Schoenfuss, Larry B. Barber, Vicki S. Blazer, David O. Norris, Alan M. Vajda. Environmental Science & Technology 2010 44 (6), 1918-1925
Connor, Stephen. "Beghosted Bodyhood: Hypochondria and the Arts of Illness." North-East Network for Medicine. Durham, 12 Jun 2008. Address.
Fraser, Jessica. "GAO calls for stricter FDA oversight of DTC drug ads." Natural NEws. N.p., 15 Dec 2006. Web. 27 Apr 2010. <http://www.naturalnews.com/021306.html>.
"A Gap in the Market." Lancet Neurology 4.9 (2005): 517. Web. 28 Apr 2010. <http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6X3F-4GWTGXT-1&_user=659639&_origUdi=B6T1B-4N3YDMC-19&_fmt=high&_coverDate=09%2F30%2F2005&_rdoc=1&_orig=article&_acct=C000035878&_version=1&_urlVersion=0&_userid=659639&md5=d677e73699ee01d66c186c1593a3de64>.
"Impact of Direct-to-Consumer Advertising." The Henry J. Kaiser Family Foundation, 01 Jun 2003. Web. 29 Apr 2010. http://www.kff.org/rxdrugs/upload/Impact-of-Direct-to-Consumer-Advertising-on-Prescription-Drug-Spending-Summary-of-Findings.pdf.
Leighton, Peter. "The Bias Against Preventative Health Care." The Leighton Post. N.p., 25 Dec 2009. Web. 27 Apr 2010. <http://leightonpost.com/tag/dtc-advertising/>.
Melville, Kate. "Prescription Drug Pollution may Harm the Environment." Science a Go Go, 01 April 2002. Web. 28 Apr 2010.
<http://www.scienceagogo.com/news/20020310224024data_trunc_sys.shtml>.
Metzl, Dr. Jonathan M. "If direct-to-consumer advertisements come to Europe: lessons from the USA." Lancet 369.9562 (2007): 704-706. Web. 26 Apr 2010. <http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4N3YDMC-19&_user=659639&_coverDate=03%2F02%2F2007&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000035878&_version=1&_urlVersion=0&_userid=659639&md5=09a2d70d43a967a1cd8bfae74fbdeab2>.
"Prescription Drug Advertising: Questions and Answers." U.S. Food and Drug Administration. U.S. Department of Health and Human Services, n.d. Web. 27 Apr 2010. <http://www.fda.gov/Drugs/ResourcesForYou/Consumers/PrescriptionDrugAdvertising/UCM076768.htm>.
Shah, Anup. "Pharmaceutical Corporations and Medical Research." Global Issues. N.p., 04 Nov 2009. Web. 27 Apr 2010. <http://www.globalissues.org/article/52/pharmaceutical-corporations-and-medical-research>.
"Stop Drug Ads." Commercial Alert, n.d. Web. 27 Apr 2010. <http://democracyinaction.org/dia/organizations/commercialalert/campaign.jsp?campaign_KEY=1415&t=stop_drug_ads_home.dwt>.
"Toxic Substances Hydrology Program." United States Geological Survey, n.d. Web. 29 Apr 2010. <http://toxics.usgs.gov/>.
Wilkes, Michael S., Robert A. Bell, and Richard L. Kravitz. "Direct to Consumer Prescription Drug Advertising: Trends, Impact, and Implications." Health Affairs 19.2 (2000): 110-128. Web. 30 Apr 2010. http://content.healthaffairs.org/cgi/reprint/19/2/110.pdf.
Sources for Pictures:
Lunesta picture- http://www.lunesta.com/lunesta-kit/tips.html?iid=LHC_sleepTips
television http://talkinstuff.files.wordpress.com/2009/05/television.jpg
Nexium- http://www.purplepill.com/
bottle of pills and yoga person http://www.lipitor.com/
peak oil graph http://www.lifeaftertheoilcrash.net/
cholesterol graph http://www.mynumberstracker.com/Images/sports%20graph.gif
peace sign http://www.flickr.com/photos/freg/2462380423/
girl with pills on face http://www.flickr.com/photos/hannaheartless/4310797015/
pill bottle and money http://leightonpost.com/tag/dtc-advertising/
Other Go Fix It! Ideas:
· Promote LED lighting and warn about mercury in CFLs
· Make more stringent qualifications for FDA employees; mandate disassociation from previous employers that are in the same industry that the FDA regulates
· Mandate distributed energy for any new corporate building
· Improve the relationship between manufacturers and recyclers